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Kettlebells for Knee Pain

According to a survey by the Center for Disease Control and Prevention, 30% of adults reported some type of joint pain during the last 30 days. Knee pain ranked as primary joint of complaint for this particular survey1.

In the world of rehabilitation, scientific literature has been pointing to the muscles of the hip as a major player in knee pain2. Strengthening the Hip Abductors (Gluteus Medius) and the Hip External Rotators have been specifically highlighted as a source of pain relief for the knee3, 4. This stands to good reason when analyzing the functional mechanics of the knee; the orientation of the knee is controlled by the position of the femoral head. The position of the femoral head is controlled by the muscles of the hip. In other words, the hip dictates the orientation of the knee in space, and thus, acts as the guide-wire for the muscles of the knee. A good directional pull from the muscles of the knee encourages good movement at the knee joint itself. Good movement decreases stress forces which then can decrease wear and tear, and, ultimately offers pain relief.

To address knee pain by strengthening the hip, kettlebells can be used as a functional therapeutic exercise. Here are a couple kettlebell exercises which can target the muscles of the hip:

High Knees

High Knees Video

The Hip Abductors are responsible for maintaining pelvic motion and femoral alignment during function. The High Knees are a great exercise for the Hip Abductors because it combines strengthening with balance. In this exercise, the lifting leg is the extremity which applies force. The stance limb is the side which is being strengthened. This exercise is performed by raising a kettlebell up by the foot until the knee of the lifting limb is at the height of hip – a “high knee”. By lifting up the kettlebell using dorsiflexion and hip flexion, a sudden downward force is created on the side opposite to the stance limb. This force then requires the hip muscles of the stance limb to engage and prevent a sudden drop in pelvic height on the lifting side. There are a couple compensatory movements to watch for including excessive leaning, lateral shifting, and forward flexion of the spine. The forward flexion of the spine is caused because when lifting the kettlebell with the “high knee” technique, the lifting extremity utilizes the hip flexors which are connected to the lumbar spine. If one does not control posture and engage the muscles of the stance limb, then the body will want to flex forward. If there is trouble with leaning or weight shifting, then a lighter weight should be used.

Side Swings

Side Swings Video

Resisting the motion of hip abduction and external rotation requires that a force is applied which encourages femoral internal rotation and adduction. One of the best exercises to apply this force and thus strengthen the muscles of the hip for knee pain is the Side Swing. By swinging the kettlebell on the side of the body, more weight is pulled over the lower extremity (and hip) you wish to strengthen. This same pull will also attempt to bring the knee and femur into a position of adduction and internal rotation. By side swinging in correct mechanics, we then resist the unwanted motion of hip internal rotation/adduction and therefore will strengthen the hip abductors and external rotators.

The Single Leg Deadlift: Golfer’s Lift Variation

Single Let Deadlift Video

This version of the Golfer’s Lift is a variation of the Single Leg Deadlift. The purpose of this exercise is to focus strengthening at the hip while limiting motion at the knee. Once again, we find ourselves in an exercise where the stance limb is the limb which is being strengthened. By moving into the combination of a deadlift and mini-lunge, the hip abductor must be activated to prevent changes in the horizontal position of the pelvis. By holding the kettlebell on the opposite side of the stance limb, additional muscle recruitment is forced upon the hip abductors. This exercise also requires that the individual is in good control of knee position; avoiding adduction and internal rotation is of key importance. Additionally, maintaining the single leg stance is an added challenge for control and balance. Do your best to limit the contact of the trailing limb. Finally, spinal posture must be preserved for safety during this exercise.

In the address of knee pain, training and strengthening the body in functional movement is always a desireable plus. Many of my patients and clients who used kettlebells for therapeutic exercise consistently remarked that the areas of complaint always felt better after kettlebell exercise. Despite the repetitive squatting motions of most swing based exercises in kettlebells, the population I encounter who most consistently express that their symptoms improve after a session with kettlebells are those who have knee problems. When the call for treating knee pain with exercise is made, I hope that kettlebells will be one of the therapies that will answer the call.

Dr. Ben Fung, PT, DPT, a licensed Physical Therapist in the state of California has written another insightful article for us, this time on the topic of using kettlebells for knee pain. Dr. Fung’s thesis on kettlebell exercise was presented and published by the American College of Sports Medicine in 2010. Dr. Fung founded “Kettlebell and Physiokinetic Fitness” which went on to become a San Diego 2011 “Best Alternative Exercise Studio” Finalist in its opening year. We are grateful to him for allowing us to publish this article on The Physical Therapy Web.

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One thought on “Kettlebells for Knee Pain”

Good advice. One additional suggestion: Perhaps first learn the exercise movements and patterns without the kettlebell. Try and get the motions down pat before adding any weight. That way you’re not putting yourself into a situation where you can potentially re-injure (or make worse) the knee.

An important note regarding the TMJ all Physical Therapists need to be aware of:

Many dentists & physicians are in need of referring their patients with persistent headaches, earaches, and facial pains related to the TMJ to other health care professionals; however they are unaware that some PTs can effectively evaluate and treat the TMJ.

There are great opportunities for PTs to assist their local dentists and help many individuals who suffer from persistent and disabling TMJ conditions. Management includes education on condition, highly effective home exercise programs and gentle mobilizations.

CRITERIA FOR ACCEPTANCE

tPhysical Therapists who are licensed or who are eligible to be licensed to practicetThere are NO prerequisites for this course

GENERAL COURSE INFORMATION

tCourse material is referenced from up to date research articlestAn easy to understand practical workbook is providedtAll instructions are provided in a clear and concise manner in order to ensure an effective and enjoyable learning experiencetNote: As this is primarily a practical course, please dress appropriately

Tax Receipts provided on course date / $30.00 is non-refundable / No refunds for cancellations 2 weeks or less before course date

tMember of the International Federation of Manipulative TherapiststCredentialed with The McKenzie Institute International

COURSE OBJECTIVES

Upon completion of the program, the Physical Therapist will be confident in applying evidence-based clinical assessment skills for the classification of individuals presenting with acute, sub-acute or persistent lumbo-pelvic pain.

Physical Therapists will also be able to confidently identify several potential contributing physical, psychosocial and general health factors to persistent / chronic pain.

Upon determining the classification and all the potential contributing factors, Physical Therapists will be able to administer the most effective treatment / management options based on the UNIQUE presentation of the patient.

tMember of the International Federation of Manipulative TherapiststCredentialed with The McKenzie Institute International

COURSE OBJECTIVES

Upon completion of the program, the Physical Therapist will be confident in applying evidence-based clinical assessment skills for the classification of individuals presenting with acute, sub-acute or persistent lumbo-pelvic pain.

Physical Therapists will also be able to confidently identify several potential contributing physical, psychosocial and general health factors to persistent / chronic pain.

Upon determining the classification and all the potential contributing factors, Physical Therapists will be able to administer the most effective treatment / management options based on the UNIQUE presentation of the patient.

Physical Therapists will be provided with workbook that will systematically guide the subjective and physical evaluation process.

CRITERIA FOR ACCEPTANCE

tThis program is restricted to Registered Physical Therapists who are licensed to practice in Canada, or PT students awaiting licensing.tThere are NO prerequisites for this programtPrior completion of previous APTEI lumbar, SI & hip courses is optional, but NOT compulsory

GENERAL COURSE INFORMATION

Tax Receipts provided on course date / $50.00 is non-refundable / No refunds for cancellations 2 weeks or less before course date